Calling overdue Mums. 40 weeks + 4. Ideas for inducing labour?

I was 14 days overdue with DD1 (natural delivery, not induced) and am now 4 days overdue with first son.

Booked for a sweep at 40 + 8 but had a sweep with DD1 and found it incredibly painful and intrusive, like the internal exams you have in labour (more painful than labour, in a way) so keen to induce naturally.

Being 'overdue' is one of the wonderful opportunities we have in life to learn to live with uncertainty...to understand the virtue of patience and that we can't control nature.

The risks to the baby of induction balances with the risks of not inducing at about 42 weeks. Between 42 and 43 weeks the risk to the baby is about the same that it was between 37 and 38 weeks. There is a small dip in perinatal mortality between 38 and 42 weeks. This can be accounted for because some babies born before 38 weeks may actually be younger than this (neither scan or menstrual dates are spot on) and are slightly more likely to have problems associated with prematurity. Then, some babies who have major abnormalities do not seem to trigger the onset of labour so readily - meaning there will be a slightly higher incidence of very poorly babies post term than there would be at term...and this is thought by many to account for most of the difference in mortality. The other baby who may be at risk from staying in post term is the small baby who is struggling to grow.

Fat and bouncy babies do not appear to be at greater risk (though simply being alive is not without some risk). I attended the birth of a baby born safely at home at 46 weeks, but the vast majority of babies arrive by 43 weeks.

Research shows that induction at 42 weeks is fairly safe...and just as safe as expectant management (monitoring more regularly). The risks from both to the healthy baby are slightly higher than with a spontaneous birth between 38 and 42 weeks...but only very very slightly. Induction is very slightly safer than taking no extra care post term (term being 42 weeks). The earlier induction is offered before labour would otherwise have started spontaneously, the higher the chance that it will end in CS.

A mother being induced at around 41+ weeks is twice as likely to need a CS...and she must remember that this major surgery adds to her (the mother's) risk quite significantly. The later induction is left the more likely it is to work...but the more likely it is that labour would have started within the next day or two...a very difficult decision!

Monitoring before 42 weeks and accepting sweeps can trigger anxiety in our professional carers, where none is warranted. There is a small chance of a sweep rupturing the membranes and this then has a negative impact of the course of events. However, it is important to monitor the baby yourself and feel confident that the frequency and nature of his or her movements feels right to you. Any unusual quietness and any unusually frenzied activity is worth having checked out straight away....don't wait several worried hours when you simply need some reassurance. After 42 weeks (and you are probably already in labour as I type), research supports more frequent monitoring, but only on the basis of a very small reduction of poor outcomes...most of which would involve the smaller growth retarded babies. The golden rule is to do what feels right and makes you feel safe. This is why pressure and coersion is so dangerous because we resist this and become out of tune with our instincts. There are no guarantees in life...but birth is about as safe as life gets!

I was 40+17 for DS1, and got induced, he came out like a rocket (4hrs) after one pessary,

For DS2 I was 40+16, and as I was 2yrs older I conceded an induction one day earlier. He would have also shot out like a rocket, but unbeknown to me I had enough fluid to sustain an elephant, and his poor little noggin couldn't push through it to the birth canal - as soon as they burst my waters though, he was out within 5 mins!

I didn't have a sweep (cervix pointing wrong way apparantly), but did have regular checks - I felt OK in myself, and the baby was not stressed, so I went with it, until I felt risk of holding on was greater than risk of induction.

Both boys 8lbs 14 and everything bonny and healthy.

I wouldn't have done it without the baby heartbeat / blood pressure check every other day - I think I also had an ultrasound at about plus 14.